4种含顺铂化疗方案治疗晚期非小细胞肺癌疗效及费用对比分析

Comparison of Four Different Cisplatin-based Chemotherapy Regimens for Advanced Non-small Cell Lung Cancer

目的比较4种含顺铂化疗方案治疗晚期非小细胞肺癌(NSCLC)的疗效及费用关系。方法153例晚期NSCLC病例分成4组:TP组(紫杉醇、顺铂)36例,GP组(健泽、顺铂)39例,NP组(长春瑞宾、顺铂)51例;MVP组(丝裂霉素、长春地辛、顺铂)27例。回顾性分析各组的近期疗效,并采用药物经济学的成本-效果分析法进行评价。结果TP组、NP组、GP组和MVP组近期有效率为27.8%、29.4%、33.3%和22.2%(P>0.05);肿瘤控制率为75.0%、68.6%、89.7%和55.6%(P<0.05);平均成本为33 204.3元、20 608.3元、27 439.0元和12 024.9元;C/E有效率为1 194.4、704.2、823.9和541.6;C/E肿瘤控制率442.7、301.8、306.0和216.3。结论4种以顺铂为基础的化疗方案对晚期NSCLC均有一定的疗效,GP方案在肿瘤控制和毒副反应方面有优势,NP方案在费用控制方面占优势。建议经济条件较好、尤其是老年晚期NSCLC患者使用GP方案;对于年龄较轻、化疗耐受性较好,而经济条件差的患者使用NP方案,可以更好地控制费用。

Objective To compare the effectiveness and expenses of four different Cisplatin - based chemotherapy regimens for advanced non - small cell lung cancer. Methods A total of 153 advanced non - small cell lung cancer cases were divided into 4 groups： 36 cases in TP group （paclitaxel, cisplatin）, 51 cases in NP group （vinorelbine, cisplatin） , 39 cases in GP group （gemcitabine, cisplatin） and 27 cases in MVP group （ mitomycin, vindesine, cisplatin）. Short - term responses and expenses of the chemotherapy regimens were compared by retrospective analysis and cost - effectiveness analysis of pharmaco -economics, respectively. Results In TP, NP, GP and MVP groups, the short - term response rates were 27.8%, 29. 4%, 33.3%, and 22.2% （P〉0.05）; tumor control rates were 75.0%, 68. 6%, 89. 7%, and 55.6% （P〈0.05）; average costs were 33 204. 3, 20 608.3, 27 439.0, and 12 024.9 yuan; C/E response rates were 1 19.4. 4, 704. 2, 823.9, and 541.6 ; and C/E rates of tumor control were 442.7, 301.8, 306.0 and 216. 3, respectively. Condusion All the four cisplatin -based chemotherapy regimens are effective in treatment of advanced non -small cell lung cancer, and GP regimen has advantages in tumor control and less toxic and side effects, NP regimen is more optimal in expense control. GP regimen is recom- mended to elderly patients with good economic condition, and NP to younger patients who have better chemotherapy tolerance and poor economic condition.